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Old 02-16-2008, 06:39 PM   #1 (permalink)
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Paper I wrote for class. What do u think?


This is the paper I wrote for my class. All input is appreciated.

My instructions were: Explain the "Disease concept of Alcoholism: to an individual who has just been arrested for DUI and who does not think they have a problem with alcohol. Include: disease concept, how medicine defines a disease. THIQ.

Alcoholism as a Disease

I understand that you recently received a DUI and do not think you have a problem with alcohol. I am not here to tell you if you are alcoholic or not. I am here to educate you on the disease of alcoholism. Over 50% of all fatal accidents involving two or more cars are alcohol related. Some of the drivers are alcoholic, some are non alcoholic. Many look at alcoholism with a judgmental and moralistic view. In 1956 the American Medical Association stated that alcoholism was a disease. It met the five criteria needed in order to be considered a disease: pattern of symptoms, chronicity, progression, subject to relapse and treatability. Alcoholism is an illness that crosses all social classes. Anyone could get it, regardless of age, sex, education, class, ethnicity or religion. Those with a family history of drinking are at a higher risk, even if they once swore they would never drink like their mother or father.

Alcoholism is a chronic, progressive disease that manifests itself with symptoms that affect one physically, mentally, emotionally, spiritually and socially. Denial is its number one symptom, and the alcoholic is usually the last one to believe he or she has it.
This disease is often described as cunning, baffling and powerful. The alcoholic is often just as puzzled as those around him or her, because no matter how he or she attempts to modify drinking, nothing seems to work. The individual just can't seem to get a "grip" on the problem. Denial is the biggest symptom of this illness, and not just for the alcoholic. Those around the alcoholic are also often in denial, believing the person just needs to stop drinking or cut down. It is only after treatment that this confusing problem begins to make sense. The alcoholic learns that he or she has a chemical reaction to alcohol and that it is the first drink that causes the trouble. That is, it's the first drink that sets the obsession to drink in motion.
The craving that an alcoholic feels for alcohol can be as strong as the need for food or water. An alcoholic will continue to drink despite serious family, health, or legal problems.
Research shows that the risk for developing alcoholism does indeed run in families. The genes a person inherits partially explain this pattern, but lifestyle is also a factor. Currently, researchers are working to discover the actual genes that put people at risk for alcoholism. Your friends, the amount of stress in your life, and how readily available alcohol is also are factors that may increase your risk for alcoholism.

But remember: Risk is not destiny. Just because alcoholism tends to run in families doesn't mean that a child of an alcoholic parent will automatically become an alcoholic too. Some people develop alcoholism even though no one in their family has a drinking problem. By the same token, not all children of alcoholic families get into trouble with alcohol. Knowing you are at risk is important, though, because then you can take steps to protect yourself from developing problems with alcohol.

Now I want to teach you about Tetrahydroisiquinoline. Otherwise known as THIQ. THIQ was discovered in brains of alcoholics in Houston, Texas by a scientist named Virginia Davis who was doing cancer research. For her study she needed fresh human brains and used bodies of homeless winos who had died during the night and were picked up by Houston police in the morning. She discovered in the brains of those chronic alcoholics a substance that is closely related to Heroin. When a person shoots heroin into their body, some of it breaks down and turns into THIQ. The Alcoholics studied had not been using heroin so how did the THIQ get there? When the normal adult drinker takes in alcohol, it is very rapidly eliminated at the rate of about one drink per hour. The body first converts the alcohol into something called Acetaldehyde. This chemical is very toxic and if it were to build up inside us, we would get violently sick and could die. But Mother Nature helps us to get rid of acetaldehyde very quickly. She efficiently changes it a couple of more times - into carbon dioxide and water - which is eliminated through kidneys and lungs. That's what happens to normal drinkers. It also happens with alcoholic drinkers, but with alcoholic drinkers something additional happens. In alcoholic drinkers, a very small amount of poisonous acetaldehyde is not eliminated. Instead it goes to the brain. There through a very complicated biochemical process, it winds up as THIQ. Research shows that THIQ is manufactured in the brain and only occurs in the brain of the alcoholic drinker. It is not manufactured in the brain of the normal social drinker of alcohol. Once the THIQ is in the alcoholic brain it never goes away. This explains the chronicity of alcoholism.

Now for the good news. And there is good news. Alcoholism is treatable, but successful recovery from alcoholism requires active participation of the individual. It is critical that the alcoholic accepts the illness and be willing to manage his or her recovery process, much like anyone with any other chronic illness has to do. Education is essential. Recovering alcoholics must be well informed about their illness and the need for good self-care. To avoid relapse, the individual needs to learn skills in treatment to maintain and enhance his or her ability to continue in recovery. Many people are able to live and enjoy life after dealing with their alcoholism.
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Old 02-16-2008, 07:18 PM   #2 (permalink)
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Nice job!

Wouldn't denial, by definition, be a sign rather than a symptom? ... Not trying to criticize, just wondering...

Thanks!
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Old 02-16-2008, 07:43 PM   #3 (permalink)
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Good point. Thanks! I do not take it as criticism at all. I appreciate the input.
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Old 02-16-2008, 07:53 PM   #4 (permalink)
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it is now come time for you to go to the head of the class sis, wanna do my thesis for me??
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Old 02-16-2008, 08:04 PM   #5 (permalink)
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Thanks!
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Old 02-16-2008, 08:07 PM   #6 (permalink)
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Old 02-16-2008, 08:15 PM   #7 (permalink)
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Well done! I'd give you an "A"--
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Old 02-16-2008, 08:22 PM   #8 (permalink)
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For a school project...Very well done. A+

For reality...

Hey buddy, you just got a DUI.

Keep drinking and you will get more or die trying. Alcoholic or not, it will happen.

If you want some answers on how to stop the madness you are in...AA meetings are a great place to find them.
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Old 02-16-2008, 10:54 PM   #9 (permalink)
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Nicely done, Tanya. A. 4.0. Dean's List. President's List. Summa *** Laude!
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Old 02-16-2008, 10:56 PM   #10 (permalink)
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"Summa *** Laude!"

They censored the Latin word for with! I wasn't being vulgar.
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Old 02-17-2008, 12:04 AM   #11 (permalink)
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Wow! Really nice job. I learned a lot from your paper. Thanks!
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Old 02-17-2008, 12:10 AM   #12 (permalink)
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read it tonight anyway - nice job Tan

I can't believe they censored *** tho

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Old 02-17-2008, 01:27 AM   #13 (permalink)
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Wow! I'm fascinated by that Tetrahydroisiquinoline bit! Maybe there should be a way to test for the presence of THIQ in people at high risk for alcoholism.
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Old 02-17-2008, 03:46 AM   #14 (permalink)
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Cool paper. I love it when people get to bring relevant subjects in their lives into the classroom. To me that is what education is really about. I bet your professor and class really benefitted from it.

A few notes on the physiology/medical terms:

"Tetrahydroisiquinoline" is spelled: Tetrahydroisoquinolone. (Don't worry - I doubt anyone noticed or cared.)

An FYI: Sign or Symptom?

This confuses everyone. "Symptoms" are descriptions reported by patients. (ie. "I feel warm doc.") "Signs" are objective indicators of a medical condition. (ie. "this patient has a temperature of 103į!") If I were taking a medical history, I would consider the behavioral aspects such as denial and lying to be symptoms because you can't objectively test for them. (ie. "Patient states he only drank one drink today, but is weaving and slurring his words." = symptom. "His BAC is .20." = sign.)

So I think you were spot on with that one Tanya.


I don't know if you turned it in yet, but the process by which acetaldehyde ends up in excess can be explained quickly to lay people. Here's how I do it for AA groups when I speak:

The liver's job is to break down toxins like alcohol into non-toxic substances via 2 reactions. The first makes a "toxic metabolite" and the second turns it into a "non-toxic metabolite". The must occur at a rate that prevents the toxic metabolite from building up.

#1: Alcohol-dehydrogenase turns alcohol from the stomach into acetaldehyde at a slow rate. This is known as the "rate limiter" for alcohol metabolism. (BTW: you're right about how acetaldehyde makes us feel sick - it is the chemical responsible for the "hangover" feeling).
#2: Acetaldehyde-dehydrogenase converts the acetaldehyde into acetone at a fast rate. (Yes. Nail polish remover.) The acetone is unstable in the liver so breaks down on it's own into carbon-dioxide and water.

In alcoholics, step #1 is too fast and step #2 is too slow. The result is that the acetaldehyde builds up and backs up into the bloodstream where it is free to hitch a ride to the brain and crash the party up there.

That's as simple as I've been able to make it and still use "doctor words".

Oh, one more thing that I think is cool: The key to the craving cycle is this acetaldehyde/THIQ balance. The brain likes the THIQ (it replaces the neurotransmitter dopamine, which alcoholics are deficient in) but it's getting acetaldehyde. The irony is that it needs to keep the acetaldehyde levels up high enough to make enough THIQ to cancel out the effects of the acetaldehyde. The poison becomes it's own antidote!

Okay, I'll stop now because I'm writing your paper for you. Feel free to use any of the above info if you like and if you haven't turned it in yet. (You'll probably want to re-write it a little better though.)

Since this is my last semester before my clinical residency, my class schedule is kind of light so I'm doing an elective research study on addiction neurochemistry and this stuff is SO cool! Kudos to you for taking on what is a fairly complex subject and explaining it so well. Awesome job.

Oh, for chirish:
Testing for THIQ would not necessarily make sense because it is not a specific chemical marker for alcoholism. As Tanya said, it IS a complex biochemical process so there is a lot more going on (she just touched on the important points).

We can however test for genetic variations in "iso-enzymes" - what alcohol-dehydrogenase (#1) and acetaldehyde-dehydrogenase(#2) are. A normal drinker will have a slow #1 and a fast #2. An alcoholic will have the fast #1 and slow #2 variation. This type of testing is already being done but it is expensive and not easily available in most labs. However, there is work currently underway to create a cheap accurate test for alcoholism using these iso-enzymes. Alcoholic parents could have their children tested for instance.

Again, good job.

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Old 02-17-2008, 04:51 AM   #15 (permalink)
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denial vs delusional!
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Old 02-17-2008, 06:15 AM   #16 (permalink)
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Thanks Tanya for posting your paper. And others who have shared info.

I'm not the scientific type, but it's easier to follow when broken up into laymans terms.

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Old 02-17-2008, 06:34 AM   #17 (permalink)
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Thanks everyone. I appreciate all of your input.

I am not too worried about putting it into simple terms as it is for a class on counseling alcohol and other drug addictions. My prof will be the one reading it and he is very knowledgeable on this topic. Much more than I am.

I will let you all know my grade when I get it. It is worth 25 points for a test I have on Tuesday.

I do love writing papers like this. It is so informative. I have been facinated by THIQ since I heard about it last semester. It answers alot of questions for me.

I think another good and controversial topic would be: If you could take a pill to get rid of the THIQ, would you??
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Old 02-17-2008, 06:49 AM   #18 (permalink)
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(((Tanya))))

Sorry I'm late on this, but I think you did a great job!

As far as your last question...I've got to think about it. If I could take a pill to keep me from becoming an addict, at first I'd say...heck ya! But, then I think....if I still have my addictive BEHAVIORS, I may not try to learn how to deal with them in a constructive way.

Don't know if that makes sense, it was a long night at work and I'm tired. I just realize that I've had to re-think my way of thinking/feeling/acting in pretty much every aspect of my life....way more than just staying clean, huh?

Hugs and prayers!

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Old 02-17-2008, 08:36 AM   #19 (permalink)
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For what its worth, I have to respectfully disagree with you Kurt on the "sign" versus "symptom" point...

"...Patient states he only drank one drink today..." -- symptom
"...but is weaving and slurring his words..." -- sign
"...His BAC is .20..." -- sign

My understanding is that the defining difference is that symptoms are reported by the patient, ("...I feel this... I experience this...") -- there is an experiential element to them -- whereas signs are not, ("...patient displays indications...", "...is clearly limping..."). Another way to look at it is to ask where does the perception occur? Who perceives the indication, the patient or the doctor?

I don't think too many people have walked into a doctor's office and said, "I am in denial about my drinking". By definition, denial is not perceived by the patient and therefore can not be a symptom. It can however, be perceived and inferred by someone who is not the patient, such as a doctor, therefore making it a sign.

My understanding is also that neither a sign nor a symptom need to be quantifiable in order to be valid. They can also be qualitative in nature... "I feel like crap" or "general malaise" are both perfectly valid symptoms, just as "exhibits poor motor control" is a perfectly valid sign. They do not need to be measured in order to be observed.

Just my two cents... Sorry if I'm off topic.
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Old 02-17-2008, 08:55 AM   #20 (permalink)
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Great job Tanya !

Re: sign vs symptom : wouldn't denial be more of a sign? If symptoms are reported by the patient I doubt they would report denial. Denial could be observed and noticed by doctors and others though.

Not that it matters... it's a good paper. I'm probably off with my reasoning anyway.

edit to add: I see that Green Tea said something similar.
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